Food and Nutrition Assistance Research Database

The RIDGE Program summarizes research findings of projects that were awarded 1-year grants through its partner institutions. All projects were conducted under research grants from ERS, and the views expressed are those of the authors and not necessarily those of ERS or USDA. For more information about publications or other project outputs for a specific RIDGE study, contact the investigator or research center that awarded the grant. For a customized list of RIDGE projects and summaries, search by keyword(s), project, research center, investigator, or year:

Good nutritional status can improve older adult’s health, help them
remain independent, and improve their quality of life. In a previous study
that evaluated 18,488 congregate and home-delivered meal participants, 66
percent and 86 percent of participants who scored at moderate and high nutritional
risk, respectively, answered “yes” to the Nutrition Screening Initiative
(NSI) Checklist statement, “I am not always able to shop, cook, and feed
myself.” Older adults’ food intake has been reported to be affected by many
factors, such as social interactions, finances, emotional well-being, transportation,
and living arrangement. However, literature is limited on the relationship
of these factors to older adults’ ability to shop, cook, and feed themselves.

The purpose of this study was to evaluate the association of theoretical factors
(mobility, social interactions, finances, emotional well-being, transportation,
living arrangement, and appliances) with the ability of participants in the
Oklahoma Older Americans Act Nutrition Program (OAANP) to shop,
cook, and feed themselves. The results of this study will enable the Oklahoma
Department of Human Services, Aging Services Division (OKDHS
ASD) to target programs and services related to participants’ ability to shop,
cook, and feed themselves, which could help to reduce participants’ nutritional
risk and to increase their ability to maintain independence.

Data were collected using a project survey that contained the NSI
Checklist statement, “I am not always able to shop, cook, and feed
myself,” and items from the U.S. Administration on Aging (AoA)
Performance Outcomes Measures Project (POMP) surveys related to
theoretical factors (mobility, social interactions, finances, emotional
well-being, transportation, living arrangement, and appliances). All
survey items were modified to pose yes/no responses. Volunteer OAANP
site managers and outreach workers were contracted to complete the project
survey with congregate and home-delivered meal participants by in-person
interviews to avoid problems if participants did not understand a survey
item or if they had difficulty reading or writing.

Chi-square analyses were used to evaluate differences in participants’
reported ability to shop, cook, and feed themselves (SCF response) between
type of meal program. Factor analysis with varimax rotation was conducted
to determine which survey items loaded into construct factors. Construct
factor scores were computed so a lower construct factor score represented
lower functionality. T-test procedure was used to evaluate differences in
construct factor scores between type of meal program and differences in
construct factor scores between participants’ SCF response by type of meal
program. Logistic regression with backward elimination was conducted to
determine which construct factor scores were most strongly associated with
participants’ SCF response by type of meal program.

The study had 859 OAANP participants volunteer to participate, 477
(56 percent) congregate and 382 (44 percent) home delivered. A significant
difference was observed in participants’ SCF responses between the types of
meal program: 8 percent of congregate meal participants compared with 82
percent of home-delivered meal participants reported that they were unable
to shop, cook, and feed themselves. As a result, data are reported by type of
meal program.

Congregate and home-delivered meal participants who reported that they
were not always able to shop, cook, and feed themselves had significantly
lower “Mobility” construct factor scores. In addition, lower “Mobility”
construct factor scores were significantly associated with lower SCF
responses in the best-fit logistic regression model for both congregate and
home-delivered meal participants. Programs and services to improve these
reported problems may include senior driving classes, chore services to
improve the interior and exterior home environment to accommodate a
disability, and access to assistive technology.

Congregate and home-delivered meal participants who reported that they were
not always able to shop, cook, and feed themselves had significantly lower
“Financial Security” construct factor scores. Congregate meal participants
also had significantly lower “Financial Management” construct factor scores.
In addition, lower “Financial Management” construct factor scores were
significantly associated with lower SCF responses in the best-fit logistic
model for congregate meal participants. These financial security issues may
indicate a need for financial management classes to address preparing and
purchasing nutritious meals on a budget, making food dollars stretch,
applying for additional food assistance programs, applying for discount
prescription cards, applying for a reverse home mortgage, asking utility
companies to average bills or reassess the due date, and accessing free or
reduced-cost public transportation in order to improve financial security.

Although home-delivered meal participants as a whole had lower “Social
Interaction” construct factor scores than congregate meal participants,
home-delivered meal participants who reported that they were not always able
to shop, cook, or feed themselves had significantly higher “Social Interaction”
construct factor scores. Additionally, higher “Social Interaction” construct
factor scores were significantly associated with lower SCF responses in the
best-fit logistic regression model for home-delivered meal participants. This
observation may indicate that home-delivered meal participants who lived
alone and were not always able to shop, cook, and feed themselves found it
necessary to establish greater social interaction in order to overcome their
inability to shop, cook, and feed themselves. Note that home-delivered meal
participants often receive other services outside of the meal program and
that these services probably provide additional social interaction.

The association of social interaction with participants’ ability to shop,
cook, and feed themselves may indicate a need to provide programs
that address establishing social networks for both home-delivered meal
participants and the community as a whole. In addition, it may be important
to include the network of informal caregivers of home-delivered meal
participants in educational programs. Informal caregivers are responsible for
providing a substantial amount of care for older adults that support good
nutrition, including shopping, cooking, and feeding. Education for informal
caregivers related to promoting good nutrition is needed. Many informal
caregivers lack the information and skills in providing encouragement to
eat, modifying food consistency, or using nutritional supplements.